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Effect of simultaneous cataract surgery and other surgical factors in intraocular pressure in the setting of retinal detachment surgery

Session Details

Session Title: Cataract 2
Session Date/Time: Saturday 21/02/2015 | 08:30-11:00
Paper Time: 09:42
Venue: Hall 1
First Author: : R.Couceiro PORTUGAL
Co Author(s): :    I. Leal   H. Proenca   M. Faria   M. Monteiro-Grillo     

Abstract Details

Purpose:

Post-operative ocular hypertension (OHT) is underestimated by most retinal surgeons, although it is a relatively frequent complication after retinal detachment (RD) surgery. Several studies have stated that simultaneous cataract surgery is related to a significant increase in intraocular pressure (IOP) in the setting of vitreo-retinal surgery. We aimed to evaluate the effect of simultaneous cataract surgery and other surgical factors in IOP when rhegmatogenous RD surgery was performed.

Setting:

Surgical Retina Department - Hospital de Santa Maria, Lisbon

Methods:

We retrospectively reviewed 143 patients who underwent surgery for rhegmatogenous RD during a 4 year period. The main outcome was post-operative OHT and we evaluated its relation to surgical risk factors (simultaneous cataract surgery, surgical technique used and type of tamponade). Exclusion criteria were the following: no pre-operative information on intraocular pressure (IOP), follow-up of less than 3 months, previous OHT/glaucoma, previous RD surgery, pre-operative choroidal detachment, intraoperative complications, early RD recurrence.

Results:

66 patients were included. 34 patients were pseudophakic and 32 patients were phakic. All phakic patients underwent simultaneous cataract surgery. We found a 37,9% incidence (25 patients) of postoperative OHT, with a 15,6 ± 6,2 mmHg rise in IOP. Most patients (88%) were diagnosed within the first 10 days after surgery. In 11 of these cases OHT resolved with ocular hypotensive therapy for a short period; 12 patients needed chronic therapy and 2 patients were submitted to glaucoma surgery. Postoperative OHT was statistically independent from simultaneous cataract surgery (P=0,5), the use of scleral buckle (P=0,1) and silicone oil tamponade (P=0,3).

Conclusions:

OHT was a frequent complication shortly after vitreoretinal surgery for rhegmatogenous RD. Ocular hypotensive therapy was used to control most cases. Simultaneous cataract surgery, scleral buckle and silicone oil tamponade were not associated with a greater risk of developing OHT.

Financial Disclosure:

NONE

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